Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | A80745 | CA |
NPI | 1033208160 |
---|---|
Provider Name | Dr. Malayattil Vijayalakshmi |
First Address | Los Alamitos, CA 90720-2018 |
Second Address | Long Beach, CA 90808-4132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |